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Vicarious Racism Stress and Disease Activity: the Black Women’s Experiences Living with Lupus (BeWELL) Study

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Background

Indirect or vicarious exposure to racism (e.g., hearing about or observing acts of racism or discrimination) is a salient source of stress for African Americans. Emerging research suggests that these “secondhand” experiences of racism may contribute to racial health inequities through stress-mediated pathways. Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease that disproportionately impacts African American women and is characterized by racial disparities in severity. Health outcomes in this population may be susceptible to vicarious racism given that SLE is shown to be sensitive to psychosocial stress.

Methods

Data are from 431 African American women with SLE living in Atlanta, Georgia in the Black Women’s Experiences Living with Lupus (BeWELL) Study (2015–2017). Vicarious racism stress was measured with four items assessing distress from (1) hearing about racism in the news; (2) experiences of racism among friends or family; (3) witnessing racism in public; and (4) racism depicted in movies and television shows. Multivariable linear regression was used to examine associations with disease activity measured using the Systemic Lupus Activity Questionnaire.

Results

Adjusting for sociodemographic and health-related covariates, vicarious racism stress was associated with greater disease activity (b = 2.15; 95% CI = 1.04–3.27). This association persisted even after adjustment for personal experiences of racial discrimination (b = 1.80; 95% CI = 0.67–2.92).

Conclusions

Vicarious racism may result in heightened disease activity and contribute to racial disparities in SLE. Our findings suggest that acts of racism committed against members of one’s racial group may have distinct health consequences beyond the immediate victim or target.

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Funding

This study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under award number R01AR065493. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Human Development and Family Studies, Auburn University, College of Human Sciences, Auburn, AL, USA

    Connor D. Martz, Thomas E. Fuller-Rowell, Kara Chung & David H. Chae

  2. Divisions of Community Health Sciences and Epidemiology, University of California – Berkeley, School of Public Health, Berkeley, CA, USA

    Amani M. Allen

  3. Department of Health Behavior and Health Systems, University of North Texas Health Sciences Center, School of Public Health, Fort Worth, TX, USA

    Erica C. Spears

  4. Department of Medicine, Division of Rheumatology, Emory University, School of Medicine, Atlanta, GA, USA

    S. Sam Lim & Cristina Drenkard

  5. Department of Epidemiology, Emory University, Rollins School of Public Health, Atlanta, GA, USA

    S. Sam Lim & Cristina Drenkard

  6. Department of Special Education, Rehabilitation and Counseling, Auburn University, College of Education, Auburn, AL, USA

    Evelyn A. Hunter

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  1. Connor D. Martz
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Correspondence to Connor D. Martz.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Institutional Review Board approval was obtained for the study.

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Martz, C.D., Allen, A.M., Fuller-Rowell, T.E. et al. Vicarious Racism Stress and Disease Activity: the Black Women’s Experiences Living with Lupus (BeWELL) Study. J. Racial and Ethnic Health Disparities 6, 1044–1051 (2019). https://doi.org/10.1007/s40615-019-00606-8

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